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Your Arthroscopic Shoulder Surgery, a Helpful Guide

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Your Arthroscopic Shoulder Surgery, a Helpful Guide Your Arthroscopic Shoulder Surgery, A Helpful Guide Albert G. Volk, MD, FAAOS One Orthopaedic Place St. Augustine, Florida 32086 904.825.0540 Ext. 221 Fax 904.825.0517 [email protected] ABOUT THE SURGEON DR. VOLK attended college at The Johns Hopkins University and received his Medical De- gree from Indiana University School of Medicine. He completed his internship and residency program with the University of Southern California Orthopedic Department in Los Angeles, California. While at USC he had the opportunity to learn from and operate with shoulder sur- geon Dr. Frank Jobe at the esteemed Kerlan-Jobe Clinic in Centinela Hospital in Los Angeles, California. Following his residency, Dr. Volk completed a sports medicine shoulder and knee arthroscopy fellowship at the Matthews Orthopedic Clinic, Orlando Regional Medical Center in Orlando, Florida. There Dr. Volk received an additional one year of intensive training in shoulder and knee arthroscopy. He treated professional athletes including professional football, baseball, and basketball players for various sports injuries. Following his one year fellowship, Dr. Volk entered into private practice in St. Augus- tine where he currently resides and practices. He has extensive experience in treating conditions of the shoulder, mostly through arthroscopic procedures. He currently is the Chief Medical Advisor for the Professional Women’s Tennis Associa- tion and continues to evaluate and treat professional players with sports related injuries. He has two board certifications with the American Board of Orthopaedic Surgeons, one in Orthopaedic Surgery and the other in Sports Medicine. WELCOME Thank you for choosing to have your arthroscopic shoul- en the recovery process. Most surgeries are performed der surgery with Albert G. Volk, MD at Orthopaedic As- on an outpatient surgery basis through three or four tiny sociates of St. Augustine. Our Team of experienced and VÃÃÊV>i`Ê>ÀÌ ÀÃV«VÊ«ÀÌÊ iðÊÊ/ ÃÊÃ}wV>ÌÞÊ compassionate professionals is dedicated to helping you lessens postoperative pain and facilitates postoperative achieve an improved level of activity and a higher quality rehabilitation with minimal scarring. of life. At Orthopaedic Associates, Dr. Volk has designed a post- Each year over 250,000 people in the United States un- «iÀ>ÌÛiÊ Ài >LÌ>ÌÊ «À}À>Ê Ì >ÌÊ ÃÊ Ã«iVwV>ÞÊ Ì>- dergo shoulder surgery. Candidates for the surgery in- lored to the type of shoulder surgery that you have un- clude those individuals with acute shoulder pain or injury `iÀ}i°Ê Ê 7 iÊ Ì iÀiÊ ÃÊ >Ê Ài«>ÀÊ vÊ >Ê ÀÌ>ÌÀÊ VÕvvÊ ÀÊ >Ê that has severely diminished their ability to perform nor- labrum, this usually entails wearing a postoperative sling mal daily activities without pain. Shoulder surgery can for a period of four to six weeks. The amount of time make a big difference in your ability to return to work, that you will need to recover is highly dependent on the sports, or other activities that you enjoy. procedure you had and on your preoperative physical conditioning. Most arthroscopic shoulder surgery patients recover quickly. New minimally invasive arthroscopic techniques The better your physical condition prior to surgery, the and improved instrumentation have allowed us to quick- quicker and more successful your recovery will be. MISSION STATEMENT / iÊ}>ÊvÊÌ iÊ« ÞÃV>ÃÊ>`ÊÃÌ>vvÊ>ÌÊ"ÀÌ «>i`VÊÃÃV>ÌiÃÊvÊ-ÌÊÕ}ÕÃÌiÊÃÊ>Ü>ÞÃÊÌ iÊÃ>i\ÊÌÊ>ÝâiÊ your total movement and performance so you can return to the quality of life you deserve as soon as possible. THE INTENDED PURPOSE OF THIS GUIDE UÊÌÊÃÊÕÀÊLiivÊÌ >ÌÊ>ÊÜi«Ài«>Ài`Ê«>ÌiÌÊ>V iÛiÃÊÌ iÊLiÃÌÊÃÕÀ}V>ÊÀiÃÕÌðÊÊ* ÞÃV>Ê«Ài«>À>Ì]Êi`ÕV>Ì]Ê continuity of care, and pre-planned postoperative activities and rehabilitation are important to creating the best results. This guidebook will give you and your caregivers everything you need to know for a rapid return to a healthy and active lifestyle. UÊ/ ÃÊ}Õ`iÊÃÊi>ÌÊÌÊi`ÕV>Ìi]ÊiVÕÀ>}i]Ê>`Êi«ÜiÀ\ÊÊÞÕÊÌ iÊ«>ÌiÌ]ÊÌ iÊv>ÞÊÀÊV>Ài}ÛiÀ°ÊÌÃÊ«ÕÀ«ÃiÊÃÊ ÌÊÀiiÛiÊvi>ÀÊ>`ÊÃÌÀiÃÃÊÌ ÀÕ} ÊÀ}>â>Ì°ÊÌÊÜÊÃiÀÛiÊ>ÃÊ>ÊÃÌi«LÞÃÌi«Ê}Õ`iÊÌÊÞÕÀÊ«Ài«>À>ÌÊvÀÊÃÕÀ}iÀÞ°Ê Furthermore, it will outline what will be expected of you before and after the surgery. DECISION FOR SURGERY You and Dr. Volk have decided that the best treatment for your shoulder problem is shoulder arthroscopy. Depending on the exact procedure and extent of the surgery will dictate: UÊÜÊ}ÊÞÕÊÜÊii`ÊÌÊÜi>ÀÊÌ iÊà Õ`iÀÊLâiÀ° UÊÜÊ>ÞÊÜiiÃÊÞÕÊÜÊii`ÊÌÊ>ÌÌi`ÊÀÌ «>i`VÊÀi >LÌ>Ì° UÊ7 >ÌÊëiVwVÊiÝiÀVÃiÃÊÌÊ`Ê>`ÊÜ iÊÌÊÃÌ>ÀÌ° UÊ7 >ÌÊÀiÃÌÀVÌÃÊÞÕÊÜÊ >ÛiÊÊÀ>}iÊvÊÌÊ>`ÊÃÌÀi}Ì i}Ê>VÌÛÌÞ° "ÀÌ «>i`VÊ,i >LÌ>ÌÊà Õ`ÊLi}ÊiÊÌÊvÕÀÊ`>ÞÃÊ>vÌiÀÊÃÕÀ}iÀÞ°Ê/ iÊwÀÃÌÊ session is to change your operative dressing and to come up with a plan for your treatment. If your orthopaedic rehabilitation is to be done at a location outside of our facility or through a home health care agency, your physical therapist should call ÕÀÊvwViÊÌÊ >ÛiÊÌ iÊ«iÀ>ÌÛiÊÀi«ÀÌÊv>Ýi`ÊÌÊÌ i°Ê/ ÃÊÜÊvÀÊÞÕÀÊ« ÞÃV>Ê therapist regarding which procedure was performed and what kind of rehabilitation to initiate. 2 Your Arthroscopic Shoulder Surgery WHAT IS A SHOULDER ARTHROSCOPY Arthro means joint and scope means to view inside that joint. An arthroscope is a small >ÀÀÜÊÌÕLiÊÌ >ÌÊÃÊÃiÀÌi`ÊÌÊÌ iÊà Õ`iÀÊÌÊÌ ÀÕ} Ê>Ê«iVÃâi`Ê iÊÌ ÀÕ} Ê Impingement 1 Ü V Ê>ÊwLiÀÊ«ÌVÊV>iÀ>]Ê} ÌÊÃÕÀVi]Ê>`ÊÜ>ÌiÀÊyÜÊ>ÀiÊ«>ÃÃi`°ÊÊ/ iÊV>iÀ>ÊÃÊV- iVÌi`ÊÌÊ>ÊL}ÊÃVÀii]Ê } `iwÌÊÌiiÛÃÊÌÀ°ÊÊ À°Ê6ÊÜÊLiÊ>LiÊÌÊÛiÜÊ the inside of your shoulder joint and identify frayed, torn, or degenerative tissue. One or more small incisions are made in the joint for insertion of special instruments used to: Torn Labrum 2 UÊ iLÀ`iÊÌ iÊ`i}iiÀ>ÌÛiÊÌÃÃÕiÊÃÊÞÊ i>Ì ÞÊÌÃÃÕiÊ remains. UÊVÀi>ÃiÊÌ iÊë>ViÊvÊÌ iÊÀÌ>ÌÀÊVÕvvÊLÞÊÀiÛ}ÊLiÊ Ã«ÕÀÃÊ>`Êy>i`ÊÀÊÌ Vii`ÊLÕÀÃ>ÊÀÊÃV>ÀÊÌÃÃÕi° UÊ,iÛiÊ>ÀÌ ÀÌÃÊvÀÊÌ iÊ Ê­>VÀV>ÛVÕ>À®ÊÌqqÕvÀ`Ê«ÀVi`ÕÀi° UÊ,i«>ÀÊÀÊÀi>ÌÌ>V Ê}>iÌÃ]Ê>LÀÕ]ÊÀÊÌÊV>«ÃÕiÊvÀÊÊà Õ`iÀÊÃÌ>LÌÞ° UÊ,i«>ÀÊ>ÊÌÀÊÀÌ>ÌÀÊVÕvv° New and improved shoulder arthroscopic inventions have led to quicker recovery times, less pain, and faster rehabilitation. REASONS FOR SHOULDER ARTHROSCOPY The reasons for shoulder arthroscopy might include: Torn Rotator Cuff 3 UÊRotator cuff tear - This is the tendon structure of the shoulder that is responsible vÀÊvÌ}ÊÞÕÀÊ>ÀÊÛiÀÊÞÕÀÊ i>`°Ê­}ÕÀiÊή UÊAdhesive capsulitisÊÊvÀâiÊà Õ`iÀ° UÊBicipital tendonitis - frayed or inflamed biceps tendon. UÊCalcific tendonitis - calcium deposits in the rotator cuff tendon. UÊHistory of dislocations or subluxation of the shoulder - shoulder instability. U Labral tears - This is a structure in the shoulder that helps to keep the shoulder in place. The labrum can become frayed, torn, or detached and may need debridement ÀÊÀi«>À°Ê­}ÕÀiÊÓ® Arthritis and Loose Bodies 4 U Acromioclavicular joint arthritis - The joint between the collar bone and the acro- ÊLiViÃÊv>i`ÊÀÊ>ÀÌ ÀÌV°Ê­}ÕÀiÊ{® U Synovitis and bursitis - The lining of the joint covering of the tendon becomes v>i`ÊÀÊÌ Vii`°Ê­}ÕÀiÊ£® U Loose bodies - A piece of cartilage can break off the covering of the joint and float vÀiiÊÊÌ iÊÌÊV>ÕÃ}ÊV>ÌV }Ê>`Ê«>°Ê­}ÕÀiÊ{® U Impingement - Usually caused by weakness or narrowing of the space between Ì iÊ ÕiÀ>Ê i>`Ê>`ÊÌ iÊ>VÀ°ÊÊ*>ÊÃÊV>ÕÃi`ÊÜ iÊÌ iÊ>ÀÊÃÊÀ>Ãi`ÊÛiÀÊ Ì iÊ i>`°Ê­}ÕÀiÊ£® U 9Ê " /" Ê"Ê/ Ê "6 ° A Helpful Guide 3 HOW TO PREPARE FOR ARTHROSCOPIC SHOULDER SURGERY UÊ*Ài«>À>ÌÊvÀÊÃÕÀ}iÀÞÊLi}ÃÊ>ÃÊÃÊ>ÃÊÞÕÀÊ`VÌÀÊÀiV- mends surgery. UÊ Ü>ÞÃÊ V>ÀÀÞÊ >Ê ÃÌÊ vÊ ÞÕÀÊ VÕÀÀiÌÊ i`V>ÌÃÊ ÜÌ Ê ÞÕ°Ê ÌÊ is very important that we, as your healthcare providers, know what medications you are taking. Your list should include the name of the medication, the dosage of the medication, how many times a day you take the medication, and at what time you take the medication. UÊ*Ài«iÀ>ÌÛiÊVi>À>ViÊÊ9ÕÊà Õ`ÊÌvÞÊÞÕÀÊv>ÞÊ`VÌÀÊ of your decision to have surgery. You may need to have an EKG to check the condition of your heart, schedule lab work, or pos- sibly a chest x-ray. UÊ ÕÀÀiÌÊi`V>ÌÃÊÊvÊÞÕÊ>ÀiÊVÕÀÀiÌÞÊÌ>}ÊL`ÊÌ - iÀÃÊÃÕV Ê>ÃÊ>ëÀ]Ê Õ>`]Ê*>ÛÝ]ÊÛÌ>Ê ]Ê>Ìy>>ÌÀÞÊ`ÀÕ}ÃÊÃÕV Ê>ÃÊ`ÛÊÀÊiÛi]ÊÞÕÊÜÊii`ÊÌÊ`Ã- cuss with your family doctor when it is safe to stop taking these medications. In most cases, these medications should LiÊÃÌ««i`ÊwÛiÊÌÊÃiÛiÊ`>ÞÃÊ«ÀÀÊÌÊÃÕÀ}iÀÞ°ÊÊiÌÊÞÕÀÊv>ÞÊ`VÌÀÊ`iV`iÊiÝ>VÌÞÊÜ iÊ>`Ê ÜÊÌÊÃÌ«ÊÌ i° THE WEEK OF SURGERY U 9ÕÊÜÊ LiÊ ÃV i`Õi`Ê >Ê «Ài«iÀ>ÌÛiÊ ÛÃÌÊ >ÌÊ "ÀÌ «>i`VÊ ÃÃV>ÌiÃÊ LivÀiÊ ÞÕÀÊÃÕÀ}iÀÞ°ÊÊvÊÞÕÊ >ÛiÊÌÊ>Ài>`ÞÊ}ÛiÊÕÀÊvwViÊ>ÊÃÌÊvÊ>ÊvÊÞÕÀÊVÕÀÀiÌÊ medications, please bring that with you for this visit. Your medical clearance, if needed, should be completed at this time. A note from your family doctor or heart doctor, any lab work, and a recent copy of your EKG should be brought ÜÌ ÊÞÕÊÀÊv>Ýi`ÊÌÊÕÃÊ«ÀÀÊÌÊÞÕÀÊvwViÊÛÃÌ°ÊÊ U vÊÞÕÊ`ÊÌÊ}ÊÌÊÞÕÀÊ«Ài«iÀ>ÌÛiÊVi>À>ViÊ>««ÌiÌÊÀÊv>ÊÞÕÀÊVi>À- ance test, the surgery will be postponed until proper clearance has been ob- Ì>i`°ÊÊ7iÊÜÊÌÊ«ÀVii`Ê>}>ÃÌÊÌ iÊ>`ÛViÊvÊ>Ì iÀÊ`VÌÀ°ÊÊ U vÊiViÃÃ>ÀÞ]ÊÞÕÊà Õ`Ê >ÛiÊ>Ài>`ÞÊÀiViÛi`ÊÃÌÀÕVÌÃÊvÀÊÞÕÀÊ«À>ÀÞÊ care doctor when to take your heart medication, blood pressure medication, or diabetes medication . If applicable, you will also have received instructions when ÌÊÃÌ«ÊÞÕÀÊ Õ>`]Ê*>ÛÝ]Ê>Ìy>>ÌÀiÃ]ÊÀÊ>ëÀ°ÊÊ U ÌÊÃÊiViÃÃ>ÀÞÊÌ >ÌÊÞÕÊÌvÞÊÕÃÊvÊÞÕÊ>ÀiÊ>iÀ}VÊÌÊ>ÞÊi`V>ÌðÊÊ >ÕÃi>ÊÃÊ not a true allergy.
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